The PMHNP is called to consult on a patient in the emergency department who has been admitted following a traumatic motor vehicle/pedestrian accident. He was walking across the street when a speeding driver crashed into him at high speed. The patient remarkably does not have serious injuries, the staff noted that he seemed a bit “odd” and decided to call for a mental health consult. The patient lives alone, has no close friends or family members to call, and appears disinterested in any discussion of interpersonal relationships.

The PMHNP recognizes that the most appropriate approach to this patient requires which of the following?

A. A warm, straightforward approach with particular attention to being non-judgmental.

B. A firm, professional approach with firm limit setting at the beginning of the encounter.

C. Particular attention to the need for insight-oriented therapy with the goal od increasing independence.

D. Referral to dialectical behavior therapy as a mechanism for promoting acceptance and change.

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YouTube: https://www.youtube.com/watch?v=CXMZcHbje1s&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=114

Which of the following laboratory abnormalities is not consistent with a female patient who drinks more than 3 alcoholic drinks daily?

A. Elevated high density lipoprotein

B. Elevated macrocytosis

C. Elevated transaminases

D. Elevated triglycerides

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YouTube: https://www.youtube.com/watch?v=XL6auWRfup8&list=PLf0PFEPBXfq5HGfNV-GbOlYHtDwd35OeG&index=113

The PMHNP is counseling a patient who wants to enter treatment for a substance use disorder. The patient has been using methamphetamine for over one year and freely acknowledges how much he likes the way it makes him feel. However, he is realizing that it is destroying his marriage, his professional reputation, and his health. He genuinely wants to stop using it, and is willing to do whatever he has to do, but admit that he has tried twice before and relapsed. Both he and his significant other do not understand why the desire to use is so powerful since there is not a true physical withdrawal phenomenon.

The PMHNP explains that there is a very strong physiological drive due to the influence of which reward neurotransmitter?

A. Serotonin
B. Glutamae
C. Norepinephrine
D. Dopamine